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Absite Topic Review General Surgery

Absite Topic Review General Surgery. Nir Hus, MD, PhD. Mount Sinai Medical Center Miami Beach. Topics. 1) BRCA-1,2. 2) Rx Postop Parotitis. 3) Rx Non-healing burn wound. Predict Increased risk BRCA-1,2 mutation. BRCA I Ovarian CA – 40% lifetime risk Male Breast CA – 1% lifetime risk

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Absite Topic Review General Surgery

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  1. Absite Topic ReviewGeneral Surgery Nir Hus, MD, PhD. Mount Sinai Medical Center Miami Beach

  2. Topics • 1) BRCA-1,2. • 2) Rx Postop Parotitis. • 3) Rx Non-healing burn wound. Nir Hus

  3. Predict Increased risk BRCA-1,2 mutation • BRCA I • Ovarian CA – 40% lifetime risk • Male Breast CA – 1% lifetime risk • BRCA II • Ovarian CA – 10% lifetime risk • Male Breast CA – 10% lifetime risk Nir Hus

  4. BRCA cont. • BRCA gene + family Hx = 60% lifetime risk of breast CA (autosomal dominant) • Bi prophylactic mastectomy w/ BRCA gene results in decreased risk of breast CA by 90% • Add TAH & BSO  decrease risk 95% • CA in a person w/ BRCA I,II carries a 50% risk of developing CA in contralateral breast. Nir Hus

  5. Parotitis • Can occur in the surgical patient and identified during the postoperative period. • Particularly in elderly • Dehydrated individuals. • Therapy should be directed toward • Rehydration • Enhancing salivation • Ensuring that no mechanical obstruction of the duct of Stensen is present • Obtaining stains and cultures • Administering antibiotics directed against S. aureus, which is the most common offending organism. • In ICU patients who are often colonized with gram-negative bacteria, the possibility of gram-negative bacterial parotitis should be considered and appropriate empiric therapy used. • I&D Nir Hus

  6. Rx Non-healing burn wound. • Q: 30 y.o veteran suffered a burn wound to arm 2nd or 3rd degree over one year ago and the wound is ulcerated. What to do next. • A: Marjolin’s tumor – need Bx Nir Hus

  7. Ulcers associated with burns • Curling’s ulcer – gastric ulcer that is associated with burns. • Marjolin’s ulcer – highly malignant squamous cell CA. Nir Hus

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